A Mathematical Model for Complete Morphological Regression in Primary Operable HER2-Positive Breast Cancer
https://doi.org/10.24060/2076-3093-2021-11-1-5-9
Abstract
Background. Breast cancer (BC) is distinguished with its biological tumour subtypes as luminal A, B, HER2-positive and triple-negative. The current clinical guidelines of the Russian Ministry of Health prescribe neoadjuvant targeted chemotherapy as combined treatment in the HER2-positive cancer subtype. An adequate model for treatment efficacy prediction in such patients had been missing to date.
Aim. Development of a mathematical model and its computer realisation for complete morphological regression estimation in patients with primary operable HER2-positive breast cancer.
Materials and methods. Statistically significant predictors were estimated with the treatment outcome data on 103 HER2- positive breast cancer cases with neoadjuvant targeted chemotherapy. A binary logistic regression model was developed to account for a dichotomous variable dependency on certain predictors.
Results and discussion. Multivariate analysis laid out a mathematical model and software “Complete morphological regression estimation in primary operable EGFR-expressing breast cancer under neoadjuvant chemotherapy”. Our results attest that the program correctly automates a systematic estimation of complete morphological regression achieved prior to neoadjuvant targeted chemotherapy and is clinically justified for optimising treatment regimens in primary operable HER2-positive BC.
Conclusion. The mathematical model and computer program developed estimate the rate of complete morphological regression achieved prior to neoadjuvant targeted chemotherapy with a high 92 % sensitivity, 97.33 % specificity and 93.21% accuracy.
About the Authors
A. E. OrlovRussian Federation
Andrey E. Orlov — Dr. Sci. (Med.), Department of Healthcare Management
Samara
O. I. Kaganov
Russian Federation
Oleg I. Kaganov — Dr. Sci. (Med.), Prof., Department of Oncology
Samara
V. N. Saveliev
Russian Federation
Vladimir N. Saveliev — Cand. Sci. (Med.), Oncology Unit (general oncology)
Samara
M. V. Tkachev
Russian Federation
Maxim V. Tkachev — Cand. Sci. (Med.), Oncology Unit (general oncology), Department of Oncology
Samara
A. P. Borisov
Russian Federation
Alexander P. Borisov — Cand. Sci. (Med.), Oncology Unit (general oncology), Department of Oncology
Samara
P. L. Kruglova
Russian Federation
Polina L. Kruglova — Outpatient Unit
Samara
References
1. Semsarzadeh N.N., Tadisina K.K., Maddox J., Chopra K., Singh D.P. Closed incision negative-pressure therapy is associated with decreased surgical-site infections: a meta-analysis. Plast Reconstr Surg. 2015;136(3):592–602. DOI: 10.1097/PRS.0000000000001519
2. Suh H., Lee A.Y., Park E.J., Hong J.P. Negative pressure wound therapy on closed surgical wounds with dead space: animal study using a swine model. Ann Plast Surg. 2016;76(6):717–22. DOI: 10.1097/SAP.0000000000000231
3. Pachowsky M., Gusinde J., Klein A., Lehrl S., Schulz-Drost S., Schlechtweg P., et al. Negative pressure wound therapy to prevent seromas and treat surgical incisions after total hip arthroplasty. Int Orthop. 2012;36(4):719–22. DOI: 10.1007/s00264-011-1321-8
4. de Glas N.A., Kiderlen M., Bastiaannet E., de Craen A.J., van de Water W., van de Velde C.J., et al. Postoperative complications and survival of elderly breast cancer patients: a FOCUS study analysis. Breast Cancer Res Treat. 2013;138(2):561–9. DOI: 10.1007/s10549-013-2462-9
5. Schoormans D., Czene K., Hall P., Brandberg Y. The impact of co-morbidity on health-related quality of life in breast cancer survivors and controls. Acta Oncol. 2015;54(5):727–34. DOI: 10.3109/0284186X.2014.998277
6. Chen J.Y., Huang Y.J., Zhang L.L., Yang C.Q., Wang K. Comparison of oncoplastic breast-conserving surgery and breast-conserving surgery alone: a meta-analysis. J Breast Cancer. 2018;21(3):321–9. DOI: 10.4048/jbc.2018.21.e36
7. Galimberti V., Morigi C., Bagnardi V., Corso G., Vicini E., Fontana S.K.R., et al. Oncological outcomes of nipple-sparing mastectomy: a single-center experience of 1989 patients. Ann Surg Oncol. 2018;25(13):3849–57. DOI: 10.1245/s10434-018-6759-0
8. Wörmann B. Breast cancer: basics, screening, diagnostics and treatment. Med Monatsschr Pharm. 2017;40(2):55–64. PMID: 29952495
9. Song E., Hu H. (eds.). Translational research in breast cancer: biomarker diagnosis, targeted therapies and approaches to precision medicine. Singapore: Springe; 2017. 418 p.
10. Pitman J.A., McGinty G.B., Soman R.R., Drotman M.B., Reichman M.B., Arleo E.K. Screening mammography for women in their 40s: the potential impact of the American cancer society and U.S. preventive services task force breast cancer screening recommendations. AJR Am J Roentgenol. 2017;209(3):697–702. DOI: 10.2214/AJR.16.17759
11. Mina L.A., Storniolo A.M., Kipfer H.D., Hunter C., Ludwig K.K. Breast Cancer Prevention and Treatment. Springer; 2016. 110 p.
12. Ring A., Parton M. (eds.) Breast Cancer Survivorship: Consequences of early breast cancer and its treatment. Cham:Springer; 2016. 114 p.
13. Practice bulletin No. 164: diagnosis and management of benign breast disorders. Obstet Gynecol. 2016;127(6):e141–56. DOI: 10.1097/AOG.0000000000001482
14. Yamamoto S., Suga K., Maeda K., Maeda N., Yoshimura K., Oka M. Breast sentinel lymph node navigation with three-dimensional computed tomography-lymphography: a 12-year study. Breast Cancer. 2016;23(3):456–62. DOI: 10.1007/s12282-015-0584-0
15. Xu Y., Bai X., Chen Y., Jiang L., Hu B., Hu B., et al. Application of realtime elastography ultrasound in the diagnosis of axillary lymph node metastasis in breast cancer patients. Sci Rep. 2018;8(1):10234. DOI: 10.1038/s41598-018-28474-y
Review
For citations:
Orlov A.E., Kaganov O.I., Saveliev V.N., Tkachev M.V., Borisov A.P., Kruglova P.L. A Mathematical Model for Complete Morphological Regression in Primary Operable HER2-Positive Breast Cancer. Creative surgery and oncology. 2021;11(1):5-9. (In Russ.) https://doi.org/10.24060/2076-3093-2021-11-1-5-9